"The deeper problem has not been resolved," Michael Bailey, spokesman for the Britain-based non-governmental organisation Oxfam International, told IPS. The only thing the WTO did, he said, is open a very small door that is difficult to pass through.

Ellen t'Hoen, of Doctors Without Borders (Médecins Sans Frontières), based in Paris, had similar criticisms. The agreement says poor countries may have greater access to generic medicines at low prices, but it will be much more difficult than it appears, "because what was agreed involves very complex rules," she said.

The accord on access to cheap medicines was reached in late August, just prior to the WTO's ministerial conference in the Mexican resort city of Cancun, which ends Sunday.

Observers of the negotiations say the consensus was the result of desperate manoeuvres to try to prove to the developing world that it can indeed find benefits in the WTO.

The agreement allows countries facing public health crises, such as HIV/AIDS, malaria or tuberculosis, to import the needed medicines from other countries that are authorised to manufacture generic drugs. The generics are usually much cheaper than their trademarked equivalents.

To make the purchase, the soliciting country -- with some exceptions -- would be subject to oversight and approval by the WTO Secretariat and its Council on Trade-Related Intellectual Property Rights (TRIPS).

Among other requirements, to carry out the imports, the medicines in question must be specially packaged and labelled, to distinguish them from commercially marketed drugs.

The agreement is very complicated, says Oxfam's Bailey. The deal involves locks on expiration dates for the patents, opening the door to clashes with the pharmaceutical giants, which do not want to give up their patents and do not want to see generics on the market.

The health rights activists argue that so many hurdles and restrictions are the result of pressure from the big drugs laboratories, which are reluctant to cede their patent rights, saying that they should be allowed to cover their investments in research and development of the medicines.

But t'Hoen states the NGOs' argument clearly: What should matter is people's health, not profit.

The world's 10 leading pharmaceutical labs are Pfizer & Pharmacia, GlaxoSmithKline, Merck & Co., Bristol-Myers Squibb, AstraZeneca, Aventis, Johnson & Johnson, Novartis, Wyeth and Eli Lilly, which together represent 58.4 percent of the global medications market, moving some 322 billion dollars a year.

Spokespersons for Eli Lilly argue that, without the patent protections, the company would not be able to recuperate the nearly 500 million dollars it spends each year on discovering and developing new medicines.

A study by the U.S. Office of Technology Assessment, which covered 25 years of pharmaceutical production, found that 97 percent of the medicinal products launched on the market were copies of existing medications, with mere cosmetic changes.

The study also found that 70 percent of the rest had been manufactured by publicly-owned laboratories, while half of the few truly new drugs developed in the private sector had to be pulled off the market due to the side effects they caused.

Poor countries should have complete freedom to decide which generic drugs to import and when, without causing conflict with anyone or clashes with the transnational pharmaceutical companies, said the Oxfam spokesman.

Meanwhile, Doctors Without Borders is urging developing countries to put the new agreement on medicines to the test, maximising the flexibility the accord, "though there isn't much."

At the WTO meeting, many of the official delegations have pointed to the accord as proof that the organisation is able to achieve consensus, despite the member states' differences of opinion.

Officials have repeated in their presentations this week that the spirit with which the drugs agreement was reached could extend to the more difficult areas of negotiation, such as agricultural trade, that are the focus of the Cancun meet.

WTO director-general Supachai Panitchpakdi said at the time of the drugs accord that it "proves once and for all that the organisation can handle humanitarian as well as trade concerns."

But the NGOs say it does not go far enough and does not merit celebration, but should be modified to provide greater benefits for poor countries that are in dire need of low-cost medicines to tackle their public health emergencies.